Physicians at the Tulane Heart & Vascular Institute recently performed a novel, minimally invasive procedure to repair an aortic dissection, a tear in the inner wall of the major blood vessel that carries blood from the heart. This may be the first time this procedure has ever been performed, as there are no previous reports of this form of repair done in the United States.

In the United States, 2,000 to 3,000 new cases of aortic dissection occur each year usually due to high blood pressure. A patient recently presented to Tulane Medical Center with the most serious form of aortic dissection, called Type A, which occurs in the upper part of the aorta near the heart. Type A aortic dissection typically requires emergency surgery to repair the blood vessel and prevent the tear from spreading to the adjacent heart valves and arteries (coronary) that supply blood to the heart.

During the traditional open heart surgical procedure for a Type A dissection, surgeons remove as much of the damaged aorta as possible, reconstruct the aorta with a synthetic tube called a graft and repair the adjacent heart valve. The recent patient at Tulane Medical Center could not undergo traditional surgery due to congestive heart failure. In an effort to save the patient’s life, a multidisciplinary team of physicians led by associate professor and vascular surgery chief Dr. Albert D. Sam II performed the aortic repair with a novel minimally invasive approach.

The team made small incisions in the groin and arm and used catheters and wires to guide a specialized graft to the damaged area of the aorta. X-ray imaging was used to precisely place the graft across the tear in the blood vessel. This approach preserved the maximum amount of aortic tissue along with the heart valves and coronary arteries which are typically removed and replaced in traditional surgery.